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Elevated CA-125 in IgG4 mesenteritis: a red herring or a disease biomarker? Case report and literature review

Mailis Michaud Maturana1, Ismini Panayotidis1, Savvas Psarelis2,3

  • 1Medical School, University College London, London, UK.

Rheumatology International
|August 26, 2018
PubMed

Insights

Mesenteric panniculitis (MP), a rare IgG4-related disease, can cause elevated Cancer Antigen 125 (CA-125) levels. These levels correlate with disease activity and improve with treatment.

Area of Science:

  • Gastroenterology
  • Immunology
  • Oncology

Background:

  • Mesenteric panniculitis (MP) is a rare chronic inflammatory condition affecting the omentum.
  • Recent research links MP to IgG4-related disease (IgG4-RD).
  • Cancer antigen 125 (CA-125) is a biomarker typically associated with ovarian cancer but can be elevated in other conditions.

Observation:

  • A case study of a 56-year-old male with IgG4-related mesenteric panniculitis is presented.
  • The patient exhibited exceptionally high CA-125 levels at disease onset.
  • CA-125 levels paralleled clinical disease activity.

Findings:

  • Treatment with steroids and rituximab led to a decrease in CA-125 levels.
  • A literature review suggests a correlation between high CA-125 levels and non-malignant inflammatory conditions like IgG4-related mesenteritis.
  • Elevated CA-125 in IgG4-RD may improve with appropriate therapy.

Implications:

  • This case highlights a potential non-malignant cause for elevated CA-125.
  • CA-125 may serve as a useful biomarker for monitoring IgG4-related mesenteric panniculitis activity.
  • Further research is warranted to explore the role of CA-125 in IgG4-RD.
Keywords:
Biomarkers, tumorCA-125 antigenImmunoglobulin GInflammationMesenteryPanniculitis, peritonealPeritoneum

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